Benefits of getting psychotherapy as a resident

[chekov]

What are your opinions about undergoing psychotherapy as a psychiatry resident? I'm interested in the practice of psychotherapy and wonder if I'll be a better psychiatrist if I pursue the experience of being a patient. Despite some traumas in the past, I'm not suffering at the moment. I'm happy, well adjusted, and reflective. I've developed good coping skills and self-awareness. My program gave out a list of psychiatrists they would recommend. Most are private practice and encourage therapy throughout residency. They charge half price ($150 per session) and insurance coverage gets it down to about $50 per session. I will devote time and money if being a patient will benefit my learning, but at this time I'm not completely convinced that I will learn much. I've tried short-term 10-session therapy in the past, but did not develop any new insights from it. Maybe I'm not giving therapy a fair try, or maybe my intuition is right and I don't need to pursue it. Any advice would be appreciated.

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[splik]

I don't think that residents should be forced to have their own personal psychotherapy, but if you are interested in having psychodynamic psychotherapy be a significant part of your future practice it is probably inexcusable not to given that personal psychotherapy is considered integral to the tripartite of psychoanalytic training (along with supervision, and seeing patients). It will be the best supervision you will get for your cases, give you a space to talk about how some of your more challenging patients are affecting you, give you an opportunity to experience psychotherapy in action which can influence your own practice (I certainly heavily drew from my own therapist's style in developing my own). In some ways, the better you are doing the more you can benefit from psychotherapy because you are not dealing with crisis or so overwhelmed with emotions. That said, I do believe if you aren't experiencing some pain, then you are less incentivized to invest in therapy and will become resistant to doing exploration that will rock the boat. The reality is that we all have difficulties that might be fruitful fodder. Psychotherapy is not great for mental illness, but it is highly beneficial for problems of living, particularly if you are experiencing internal conflicts, or feeling stuck in your life, or searching for meaning or satisfaction. You will learn a lot about yourself that may surprise you if you come with an open mind and have the opportunity to work with a great therapist. See if you can get a recommendation from one of your supervisors for people they think would be a good fit for you.

The risks are it could be painful, it could destroy your relationship/marriage, you could become terribly depressed/psychotic, it's costs money even though heavily discounted, it's another thing in the week to put in a hectic schedule

 

[Doctor Bagel]

What are your opinions about undergoing psychotherapy as a psychiatry resident? I'm interested in the practice of psychotherapy and wonder if I'll be a better psychiatrist if I pursue the experience of being a patient. Despite some traumas in the past, I'm not suffering at the moment. I'm happy, well adjusted, and reflective. I've developed good coping skills and self-awareness. My program gave out a list of psychiatrists they would recommend. Most are private practice and encourage therapy throughout residency. They charge half price ($150 per session) and insurance coverage gets it down to about $50 per session. I will devote time and money if being a patient will benefit my learning, but at this time I'm not completely convinced that I will learn much. I've tried short-term 10-session therapy in the past, but did not develop any new insights from it. Maybe I'm not giving therapy a fair try, or maybe my intuition is right and I don't need to pursue it. Any advice would be appreciated.

Are you an intern? If so, it might make sense to settle into your life and training a little before starting psychotherapy. As is, you won't have psychotherapy patients until 2nd year at the soonest, which is when psychotherapy to help you be a better psychotherapist might become more relevant. I do think that if psychotherapy is going to be a focus of your work, especially psychodynamic/psychoanalytic psychotherapy, then doing that work on your own is important. As splik mentioned, it's also required for analytic training.

I do think that people who say they're doing therapy just to be better therapists are likely lying to themselves (although it certainly makes a nice, safe lie in a world where getting our own mental health treatment is frowned upon).

 

[splik]

I do think that people who say they're doing therapy just to be better therapists are likely lying to themselves (although it certainly makes a nice, safe lie in a world where getting our own mental health treatment is frowned upon).

Ha, yes no therapist is going to believe it if that's what you say when you come along. they'll be like: why are you really here? and if you insist its just for your own training they will note down your resistance!!

 

[chekov]

Good points. I'm currently an intern, and training is a big part of why I had interest in getting my own psychotherapy. I find the distinction between professional training and personal development unnecessary. They are very much entwined, especially in this field. I have an open mind and want to rock the boat. I seek pain/discomfort because I see it as a necessary component for growth. Part of the reason I was dissatisfied with a trial of short term therapy in the past was because I did not experience pain/discomfort that brought me to new insights (maybe because my therapist was a relatively inexperienced resident). I would also hesitate to suggest that therapy can cause a terrible depression or psychosis. But you're certainly right that there are risks! The risks are what appeal to me.

 

[splik]

well I'm telling you that people do become terribly depressed and occasionally psychotic in the course of analytic therapy. this is not controversial. some people even believe encouraging regression is health or necessary do if you weren't borderline before you will be soon

I agree with DB I would wait until you start seeing your own psychotherapy cases you have enough going on in intern year and presumably it would be quite difficult to fit in your schedule at the point particularly when off service

 

[Shikima]

Back in the day, psychiatry residents did undergo psychotherapy as part of the training.
May be a good idea to bring it back along with 3 hours of supervision a week.

 

[splik]

Back in the day, psychiatry residents did undergo psychotherapy as part of the training.
May be a good idea to bring it back along with 3 hours of supervision a week.

it was a requirement at my program to have your own personal therapy and I strongly object to the notion you have to have your own therapy to be a psychiatrist. it's like court mandated treatment - people should only have it if they want it, defeats the purpose if you feel forced. I have my defenses for a reason and don't take kindly to them being analyzed

 

[smalltownpsych]

Psychotherapy as we conceptualize it now in the post-Freudian era is an odd thing to try to engage in without a specific goal in mind. For the sake of personal enrichment and growth in the absence of significant pathology, I believe that various types of supportive groups are probably more effective. Not necessarily professionally facilitated psychotherapy groups either. For example, several of my employees, therapists and lay staff, participated in a weekly men's group that they found quite supportive and enriching. Also, members of religious groups or 12 step groups report a similar positive continued growth dynamic. I have had several non-pathological training therapists come to me for psychotherapy in the past and it really seemed like a waste of everyone's time, but I sort of have a belief that people without significant trauma or dysfunction should be able to form good supportive relationships in the real world so they don't really need me. Besides normal patients also tend to bore me. I would rather have an out of control patient with Borderline PD any day of the week.

 

[chekov]

@splik, I didn't realize psychotherapy can cause depression or psychosis. Will have to read more about it. In the end, I guess you were able to gain a few techniques from having mandatory therapy but did not feel that it was worth it. Please correct me if I'm wrong.

Thank you everyone for your thoughts. I'm leaning towards not seeking out therapy at this time. Feeling a little guilty since I went for a first session and might cancel the next appointment with a week's notice. I don't like to waste anyone's time.

 

[smalltownpsych]

@splik, I didn't realize psychotherapy can cause depression or psychosis. Will have to read more about it. In the end, I guess you were able to gain a few techniques from having mandatory therapy but did not feel that it was worth it. Please correct me if I'm wrong.

Thank you everyone for your thoughts. I'm leaning towards not seeking out therapy at this time. Feeling a little guilty since I went for a first session and might cancel the next appointment with a week's notice. I don't like to waste anyone's time.

A weeks notice for a cancel? You obviously are too high functioning to need treatment. Don't worry, that slot will get filled.